Individual provider Active NPI

Adrienne G Grande, PA

  • Physician Assistant
  • Roslyn, NY
National Provider Identifier
1992991210
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005022 Issued in NY
Practice address
100 PT Washington Blvd
Roslyn, NY 11576
Phone
(516) 338-5300
Fax
(516) 333-1075
NPI assigned
Sep 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 005022 NY Primary

Addresses

Primary practice location

100 PT Washington Blvd
Roslyn, NY 11576

Mailing address

100 PT Washington Blvd
Roslyn, NY 11576
Phone (516) 338-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
005022NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Hospital Past Accepting new patients
St Francis Hospital United States Catholic Conference Past Accepting new patients
Leonardo N Saulle MD PC Past Accepting new patients
Northshore Hospitalist Associates PLLC Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1992991210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "11576",
            "telephone_number": "516-338-5300",
            "fax_number": "516-333-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "11576",
            "telephone_number": "516-338-5300",
            "fax_number": "516-333-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDE",
        "first_name": "ADRIENNE",
        "middle_name": "G",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.